Nebivolol

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Nebivolol (brand name Bystolic) — Antihypertensive; Selective beta-1 blocker with nitric-oxide-mediated vasodilation.

Identification

• Therapeutic class: Antihypertensive.
• Pharmacologic class: Selective beta-1 blocker with nitric-oxide-mediated vasodilation.

Pharmacology

• Mechanism of action: Beta-1 blockade plus vasodilation through nitric oxide release.
• Onset / peak / duration: Peak about 1.5 to 4 hours; duration 24 hours.
• Half-life / therapeutic level: Half-life 12 to 19 hours; no routine level.

Clinical use

• Indications: Hypertension.
• Usual dose, route, frequency: 5 to 40 mg PO once daily.
• Maximum dose / adjustments: Max 40 mg/day; reduce in renal or hepatic impairment.

Safety

• Contraindications: Severe bradycardia, heart block, decompensated heart failure, severe hepatic impairment.
• Black box warning: No formal box; warning against abrupt discontinuation.
• Interactions: Calcium channel blockers, CYP2D6 inhibitors, other antihypertensives.
• Pregnancy / lactation: Use only if clearly needed.
• High-alert: No.

Adverse effects

• Common side effects: Headache, fatigue, dizziness, bradycardia.
• Serious effects to report: Symptomatic bradycardia, heart block.
• Antidote / reversal: Atropine, glucagon for refractory overdose.

Nursing process

• Assessment before administration: Heart rate, blood pressure.
• Interventions during therapy: Hold for bradycardia; taper to stop.
• Monitor: Heart rate, blood pressure.
• Evaluation / expected outcome: Blood pressure at goal.

Patient teaching

• Patient teaching: Daily pulse check; do not stop abruptly.
• Notify provider if: Very slow heartbeat, fainting.
• Administration tips: With or without food.